Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy
In this study, we explored the association between paranasal sinus invasion and prognosis in patients with advanced nasopharyngeal carcinoma (NPC, (T3/T4N0–3M0), and we assessed the possibility of considering paranasal sinus invasion a T category in the 8th edition of the American Joint Committee on...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-11-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2020.01465/full |
| _version_ | 1818268375021780992 |
|---|---|
| author | Yajie Zhao Qin Zhou Na Li Liangfang Shen Zhanzhan Li |
| author_facet | Yajie Zhao Qin Zhou Na Li Liangfang Shen Zhanzhan Li |
| author_sort | Yajie Zhao |
| collection | DOAJ |
| description | In this study, we explored the association between paranasal sinus invasion and prognosis in patients with advanced nasopharyngeal carcinoma (NPC, (T3/T4N0–3M0), and we assessed the possibility of considering paranasal sinus invasion a T category in the 8th edition of the American Joint Committee on Cancer staging system. We enrolled 352 NPC patients who received intensity-modulated radiotherapy between 2008 and 2012. Clinical characteristics and follow-up data were collected. The incidence of paranasal sinus invasion was 36.4% (128 of 352 patients). Multivariate cox regression analysis indicated that paranasal sinus invasion and cervical lymphatic metastasis were independent negative prognostic factors for overall survival (OS, P=0.024, P=0.012), progression-free survival (PFS, P=0.007, P=0.007), and distant metastasis-free survival (DMFS, P=0.001, P=0.000). The gross tumor volume of the nasopharynx was an independent negative prognostic factor for OS (P=0.013). Cox regression analysis indicated that there were no significant differences in OS, PFS, DMFS, or local relapse-free survival (LRFS) between NPC patients with T4 stage disease and those with T3 and paranasal sinus invasion (P>0.05). The updated T + N staging system slightly improved the prediction of LRFS (0.649, 95% CI: 0.553–0.745) in NPC patients compared to the AJCC system (0.640, 95% CI: 0.545–0.736; P=0.023). Paranasal sinus invasion is independently associated with a poor prognosis in NPC patients. Thus, we recommend that the AJCC staging system upgrade paranasal sinus invasion to the T4 classification. |
| first_indexed | 2024-12-12T20:37:29Z |
| format | Article |
| id | doaj.art-b5435ab60cb54aa68356d13200a894f9 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-12T20:37:29Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-b5435ab60cb54aa68356d13200a894f92022-12-22T00:12:51ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-11-011010.3389/fonc.2020.01465560904Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving RadiotherapyYajie Zhao0Qin Zhou1Na Li2Liangfang Shen3Zhanzhan Li4Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, ChinaIn this study, we explored the association between paranasal sinus invasion and prognosis in patients with advanced nasopharyngeal carcinoma (NPC, (T3/T4N0–3M0), and we assessed the possibility of considering paranasal sinus invasion a T category in the 8th edition of the American Joint Committee on Cancer staging system. We enrolled 352 NPC patients who received intensity-modulated radiotherapy between 2008 and 2012. Clinical characteristics and follow-up data were collected. The incidence of paranasal sinus invasion was 36.4% (128 of 352 patients). Multivariate cox regression analysis indicated that paranasal sinus invasion and cervical lymphatic metastasis were independent negative prognostic factors for overall survival (OS, P=0.024, P=0.012), progression-free survival (PFS, P=0.007, P=0.007), and distant metastasis-free survival (DMFS, P=0.001, P=0.000). The gross tumor volume of the nasopharynx was an independent negative prognostic factor for OS (P=0.013). Cox regression analysis indicated that there were no significant differences in OS, PFS, DMFS, or local relapse-free survival (LRFS) between NPC patients with T4 stage disease and those with T3 and paranasal sinus invasion (P>0.05). The updated T + N staging system slightly improved the prediction of LRFS (0.649, 95% CI: 0.553–0.745) in NPC patients compared to the AJCC system (0.640, 95% CI: 0.545–0.736; P=0.023). Paranasal sinus invasion is independently associated with a poor prognosis in NPC patients. Thus, we recommend that the AJCC staging system upgrade paranasal sinus invasion to the T4 classification.https://www.frontiersin.org/articles/10.3389/fonc.2020.01465/fullnasopharyngeal carcinomaparanasal sinusprognosisstaging systemCox regression |
| spellingShingle | Yajie Zhao Qin Zhou Na Li Liangfang Shen Zhanzhan Li Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy Frontiers in Oncology nasopharyngeal carcinoma paranasal sinus prognosis staging system Cox regression |
| title | Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy |
| title_full | Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy |
| title_fullStr | Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy |
| title_full_unstemmed | Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy |
| title_short | Paranasal Sinus Invasion Should Be Classified as T4 Disease in Advanced Nasopharyngeal Carcinoma Patients Receiving Radiotherapy |
| title_sort | paranasal sinus invasion should be classified as t4 disease in advanced nasopharyngeal carcinoma patients receiving radiotherapy |
| topic | nasopharyngeal carcinoma paranasal sinus prognosis staging system Cox regression |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2020.01465/full |
| work_keys_str_mv | AT yajiezhao paranasalsinusinvasionshouldbeclassifiedast4diseaseinadvancednasopharyngealcarcinomapatientsreceivingradiotherapy AT qinzhou paranasalsinusinvasionshouldbeclassifiedast4diseaseinadvancednasopharyngealcarcinomapatientsreceivingradiotherapy AT nali paranasalsinusinvasionshouldbeclassifiedast4diseaseinadvancednasopharyngealcarcinomapatientsreceivingradiotherapy AT liangfangshen paranasalsinusinvasionshouldbeclassifiedast4diseaseinadvancednasopharyngealcarcinomapatientsreceivingradiotherapy AT zhanzhanli paranasalsinusinvasionshouldbeclassifiedast4diseaseinadvancednasopharyngealcarcinomapatientsreceivingradiotherapy |